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通过血清和头发检测评估要求自愿终止妊娠的女性接触精神活性物质的情况。

Exposure to psychoactive substances in women who request voluntary termination of pregnancy assessed by serum and hair testing.

机构信息

Legal Medicine, University of Murcia, Murcia, Spain.

出版信息

Forensic Sci Int. 2010 Mar 20;196(1-3):22-6. doi: 10.1016/j.forsciint.2009.12.042. Epub 2010 Jan 8.

Abstract

Drug abuse is a worldwide phenomenon with significant health and socioeconomic impact and it is of particular concern in women of reproductive age and in pregnant women. We aimed to investigate the prevalence of drug use by serum and hair testing in a cohort of pregnant women at 12th week gestation who decided voluntarily to interrupt their pregnancy and to investigate the relationship between drug exposure and induced abortions (IA), repeated IA and contraception. The study was conducted in an obstetrics clinic authorised to perform IA in Murcia, Spain during an 18 months period (2007-2009). Apart from serum and/or hair testing, the 142 women enrolled in the study completed a detailed questionnaire regarding drug, alcohol and tobacco use in the previous 3 months. Serum and hair samples were analyzed by gas chromatography mass spectrometry assays. Hair and serum samples showed a 30% overall positivity to drugs of abuse. Of these samples, 20.4, 14.1, 4.2 and 1.4% were positive for cannabinoids, cocaine, opiates, and MDMA, respectively, with polydrug use in 5.6% cases. In this cohort, a positive association was found between drug use and repeated IA. The results highlight the need for promoting pregnancy planning for young women in general, especially when consuming psychoactive substances as well as promote safe and accessible contraception in women of reproductive age. In women requesting IA, specific drug abuse counselling should be implemented.

摘要

药物滥用是一个全球性的现象,对健康和社会经济都有重大影响,尤其是对育龄妇女和孕妇而言。我们旨在调查在自愿决定终止妊娠的 12 孕周孕妇中,通过血清和毛发检测药物使用的流行率,并调查药物暴露与人工流产(IA)、重复 IA 和避孕之间的关系。该研究在西班牙穆尔西亚的一家妇产科诊所进行,该诊所获准在 18 个月期间(2007-2009 年)进行 IA。除了血清和/或毛发检测外,纳入研究的 142 名妇女还完成了一份关于过去 3 个月内药物、酒精和烟草使用的详细问卷。血清和毛发样本通过气相色谱-质谱联用分析进行分析。毛发和血清样本显示滥用药物的总体阳性率为 30%。其中,大麻素、可卡因、阿片类药物和 MDMA 的阳性率分别为 20.4%、14.1%、4.2%和 1.4%,5.6%的病例存在多药使用。在这个队列中,药物使用与重复 IA 之间存在正相关关系。结果强调了需要促进一般年轻女性的妊娠计划,尤其是在使用精神活性物质时,以及在育龄妇女中促进安全和可获得的避孕措施。对于要求进行 IA 的妇女,应实施特定的药物滥用咨询。

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